http://hdl.handle.net/10147/76254 Thu, 23 May 2013 19:33:55 GMT 2013-05-23T19:33:55Z http://hdl.handle.net/10147/292543 Title: Using evidence to develop services for children and families: some considerations and challenges for the Child & Family Support Agency Authors: McKeown, Kieran Mon, 01 Apr 2013 00:00:00 GMT http://hdl.handle.net/10147/292543 2013-04-01T00:00:00Z http://hdl.handle.net/10147/292514 Title: Using HIPE data for research and audit: Critical factors for success Authors: Wiley, MM Description: The Hospital Inpatient Enquiry is funded by the HSE and collects information on day and inpatient discharges from the acute public hospital system in Ireland. The Health Research & Information Division at the ESRI manages the HIPE system on behalf of the HSE. As data from the HIPE system are increasingly being used for a wide range of applications, audits of HIPE data by clinical teams are also expanding. This is a very positive development as greater involvement by clinicians in validating clinical data reported to national information systems is to be welcomed. Wed, 01 May 2013 00:00:00 GMT http://hdl.handle.net/10147/292514 2013-05-01T00:00:00Z http://hdl.handle.net/10147/292508 Title: The difficulty identifying intoeing gait in cerebral palsy Authors: O’Sullivan, R; Kiernan, D; Walsh, M; O Brien, T Description: In-toeing in children with cerebral palsy can lead to functional difficulties during gait. This may require surgical management to restore a normal foot progression angle. For this reason it is important to indentify the presence of internal rotation and to establish where the abnormal rotation is occurring. This can be done relatively easily in otherwise healthy subjects by examining foot progression angle as the subject walks towards the assessor. In cerebral palsy the often severely affected gait pattern and potential asymmetry at the pelvis means that in-toeing may be more difficult to identify. Gait laboratory data of 245 subjects with cerebral palsy were studied retrospectively. Of these 102 (41.63%) demonstrated in-toeing relative to the pelvis of one or both limbs. Eleven diplegic subjects (16.18%) in-toed bilaterally giving a total of 113 in-toeing limbs for analysis. Of those, 17 (50%) hemiplegic limbs and 20 (25.32%) diplegic limbs demonstrated a foot progression angle within normal limits due to compensations at the pelvis Wed, 01 May 2013 00:00:00 GMT http://hdl.handle.net/10147/292508 2013-05-01T00:00:00Z http://hdl.handle.net/10147/292501 Title: Predictors of the change in bilirubin levels over twelve weeks of treatment with atazanavir Authors: Cotter, Aoife G; Brown, Aisling; Sheehan, Gerard; Lambert, John; Sabin, Caroline A; Mallon, Patrick WG Abstract: AbstractObjectiveTo determine the factors associated with change in bilirubin concentration 12 weeks after the initiation of an atazanavir (ATV)-containing antiretroviral regimen.MethodsWe performed a retrospective case note review of all patients prescribed ATV between January 2004 and October 2007 in a cohort of HIV infected subjects. Data collected included baseline demographics, hepatitis B and C serology, current antiretroviral therapy, baseline and week 12 routine bloods. The primary endpoint was the change in bilirubin concentration at 12 weeks after start of ATV. Multvariable linear regression was performed to assess the relationships between the change in bilirubin and variables of interest. Results: Eighty-three ATV-treated patients were included in the analysis of whom 46 (60.5%) were hepatitis C antibody positive. The median (interquartile range) change in bilirubin by week 12 was 16 (4, 22) umol/L; only 1 patient developed grade 4 hyperbilirubinaemia at week 12. After controlling for baseline bilirubin levels, HCV seropositivity and baseline ALP were associated with a smaller change in bilirubin over the 12 weeks with a trend towards lower increases in those receiving tenofovir. Sensitivity analyses reported similar associations with methadone use and injection drug use, when these variables replaced HCV sero-positivity in the model. Conclusion: Patients with hepatitis C co-infection experience smaller changes in bilirubin upon exposure to ATV. Although the underlying mechanism for this association remains unclear, these data support the safe use of this drug in this patient setting. Further research into the clinical predictors of ATV-related hyperbilirubinaemia is warranted. Thu, 16 May 2013 00:00:00 GMT http://hdl.handle.net/10147/292501 2013-05-16T00:00:00Z